Updated with responses from CNPP, June 24, 2019. The complete letter from CNPP can be viewed here. Blog updated Aug 1, 2019.
by Nina Teicholz
The advisory committee appointed to oversee the science for the next set of Dietary Guidelines, in 2020, held its inaugural meeting last month—with some startling surprises. Most extraordinary was the government’s assertion that at a time when 60% of the population is afflicted with some kind of nutrition-related disease, the Guidelines will continue to be a policy for healthy Americans only.
With such a narrow focus, this policy is on track to do virtually nothing to reverse the epidemics of disease that are causing enormous suffering as well as bankrupting our country. What’s more, this narrow scope could be illegal. A 1990 law states that the Dietary Guidelines must be for the “general public” (Sec. 301)—which is now rightly defined as those of us with nutrition-related diseases.
One committee member took issue with this narrow focus, querying the USDA staff: “But if you excluded such people [with a particular disease condition]…that would not actually be representative of who lives in this country” (Day 1, Afternoon, 47:00). Exactly.
Dietary Guidelines Only for “Healthy Americans”
It’s a secret of sorts that the Guidelines exclude people with obesity, diabetes, dementia, heart disease, or other diseases tied to nutrition. After all, the Guidelines virtually dictate feeding programs for people who are both sick and well—“captive” populations in settings such as schools, hospitals, nursing homes and more. The Guidelines are also downloaded as the virtual “gold standard” by medical doctors, nutritionists, dieticians, and nurses alike.
Thus, if you are suffering from obesity, diabetes, dementia, high blood pressure or more, professionals will hand you the government’s one-size-fits-all diet, designed exclusively for healthy people.
This is the equivalent of doling out size 2 clothing to everyone, when more than half the population now wears XXL. It’s not only inappropriate but simply a bad fit--and bad public policy.
Why is the government’s diet not appropriate for those of us who are fat and sick? The last two decades of science indicate that many people with nutrition-related diseases typically have a "‘broken’ metabolism which reduces their tolerance of carbohydrates—found most commonly in grains and sugars. While some people can reverse obesity and diabetes by calorie restriction, others find more success restricting only carbohydrates.
Worse, these people are ill-served by the government’s diet that mandates 50-55% of daily calories as carbohydrates. Indeed, when the American Diabetes Association recently re-issued its guidelines, it stated that a low-carbohydrate diet was the most effective approach for glucose control, which is an essential component in the prevention and management of type 2 diabetes.
Despite this, the USDA’s review of the science for the 2020 Guidelines will not consider this new evidence, because many of the relevant studies have been conducted on sick populations--who are deemed outside the scope of the Guidelines’ process.
USDA officials stated at the meeting that they will not include exclusively studies on sick populations, because the Guidelines are only for healthy Americans.(Day 1, Afternoon, 20:16) [UPDATE: CNPP stated that it will look at studies on people with chronic, nutrition-related diseases but not if those studies look exclusively at people with those diseases. Presumably this means that a study would need to include a mixed population of healthy and unhealthy people to be included in CNPP’s reviews. We’ve followed up to confirm. If true, this criteria would be rather bizarre, because many studies are tailored to narrow populations, in order to obtain clearly delineated conclusions, and are therefore not likely to fit CNPP criteria.]